Provider Demographics
NPI:1629962030
Name:NELSON, LINDSAY BETH (MA)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:BETH
Last Name:NELSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 DEKALB AVE STE 125
Mailing Address - Street 2:
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-2753
Mailing Address - Country:US
Mailing Address - Phone:815-991-5760
Mailing Address - Fax:
Practice Address - Street 1:1715 DEKALB AVE STE 125
Practice Address - Street 2:
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-2753
Practice Address - Country:US
Practice Address - Phone:815-991-5760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.008277235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist